title: Comparison of Medical Costs of Patients With Atrial Fibrillation Unsuitable for Warfarin Treatment With Apixaban or Aspirin Based on AVERROES Trial.
abstract: BACKGROUND
  The AVERROES trial name is the following: The Apixaban Versus Acetylsalicylic Acid (ASA) to Prevent Stroke in Atrial Fibrillation Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment (AVERROES) trial demonstrated that apixaban reduced the risk of stroke relative to aspirin, without significantly increasing major bleeding risk in patients with atrial fibrillation (AF) considered unsuitable for warfarin therapy. Based on AVERROES trial results, this study compared the medical costs for clinical end points among patients with AF treated with either apixaban or aspirin.
  
  
  METHODS
  Medical costs per patient-year for clinical events were determined. Based on clinical event rates for patients in the AVERROES trial, medical costs excluding drug costs were estimated for apixaban- and aspirin-treated patient groups.
  
  
  CONCLUSIONS
  Based on AVERROES trial results, among patients with AF unsuitable for warfarin therapy, apixaban use was estimated to be associated with a mean medical cost avoidance of US$735 in a patient-year relative to aspirin. The primary driver was the significant reduction in ischemic stroke rate. The medical cost reduction associated with apixaban use was consistent in sensitivity analyses.
authors.affiliation: Department of Medicine, Hospitalist Program, School of Medicine, University of California, Irvine, CA, USA anamin@uci.edu.
authors.forename: Alpesh
authors.initials: A
authors.lastname: Amin
authors.affiliation: Medical Affairs, Ochsner Clinic Foundation, New Orleans, LA, USA.
authors.forename: Steve
authors.initials: S
authors.lastname: Deitelzweig
authors.affiliation: Medical Affairs, Bristol-Myers Squibb, Plainsboro, NJ, USA.
authors.forename: Yonghua
authors.initials: Y
authors.lastname: Jing
authors.affiliation: Medical Affairs, Bristol-Myers Squibb, Plainsboro, NJ, USA.
authors.forename: Dinara
authors.initials: D
authors.lastname: Makenbaeva
authors.affiliation: Medical Affairs, Pfizer, New York City, NY, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wiederkehr
authors.affiliation: Health Economics and Outcomes Research, Novosys Health, Flemington, NJ, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Lin
authors.affiliation: Medical Affairs, Bristol-Myers Squibb, Plainsboro, NJ, USA.
authors.forename: John
authors.initials: J
authors.lastname: Graham
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage / Q000191:economics; D001241:Aspirin / Q000008:administration & dosage / Q000191:economics; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000191:economics; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D011720:Pyrazoles / Q000008:administration & dosage / Q000191:economics; D011728:Pyridones / Q000008:administration & dosage / Q000191:economics; D014859:Warfarin / Q000008:administration & dosage / Q000191:economics
chemical_list: D000925:Anticoagulants; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban; D014859:Warfarin; D001241:Aspirin